Mad Worlds

by Bill Douglas

  “Thanks, but I’d like to try the bus.”

  “Well – I hope the visit goes okay.”

  “So do I. Last time was so horrible.”

  “He was a swine to you. Look, Heather, I doubt they’ll ever release him, with his mental condition.”

  Exactly what she feared. Was Sam going somewhere with this? “Really?”

  “Yes, from my knowledge of Springwell, I’m certain. It’s sad for you, and for Becky.” He paused, gazing at her. “You could have grounds for divorce.”

  “Could I?”

  “Yes. If John’s ‘of unsound mind’ for long enough. I’d then want to propose marriage – but any romance with a patient or spouse means the sack.”

  “So?”

  “Heather, I love you enough to risk my career. If we can express our feelings towards each other fully, here, without anyone else knowing – well, I’d want that.” He stood up. “I have to go. Think about what I’ve said.”

  Stunning, what he was suggesting. An affair! She rose. “Thanks Sam. I will. Remember what I’ve said too.”

  She hung back from the doorway while he said good-bye. She didn’t trust her feelings with another hug.

  Saturday 19th January 1957 – in Springwell.

  Heather leapt off the bus and walked briskly down Springwell’s Hospital Lane. The last few days, a powerful urge to take up Sam’s offer had been vying with a longing for the John she’d married. Maybe this visit could help calm her inner maelstrom.

  Keys clanked as the imposing front door opened to reveal a familiar face. Jock Mackenzie, whom Sam had called ‘one of the good guys’.

  “Hurry in lass, out o’ the cold. I remember you, Missus Chisholm, from when you came to see your man.”

  “That’s right, Mr Mackenzie. I’m told John’s on the Annex.”

  She followed him to the desk, where the visitors’ book lay. They went through the formalities – again irritating, as this swallowed precious visiting time.

  Mackenzie showed her to a seat. “I’ll ring, and your man’ll be brought down.”

  The hall was no longer spooky! They’d painted the walls in brighter colours and hung pictures. And there was a buzz of conversation – seemed like patients having visitors.

  A door at the far end slammed. She looked up. A white-coated man was pointing her way. John was striding towards her. She got up, smiling, but stood waiting, uncertain of how he’d be. Only another few steps. He looked thinner, fitter, and more smartly dressed than before.

  He stood facing her, his arms spread wide. “Heather, come here.”

  Wrapping her arms round his neck, she felt his reassuring strength enfold her. Her lips found his. She stood savouring his intimacy. He was rocking her from side to side, like he used to do. That this would last.

  She felt him withdraw and she did likewise. She sat on a chair and he drew up one beside her. She dabbed her face with her sleeve. “How are you, John?”

  “Chuffed at your visit.” He was frowning? “But I won’t blame you if you’ve shacked up with somebody else.”

  Telepathy? Her cheeks felt warm. He was waiting for her reply. “No. When I wanted to visit before, they said you were having shock treatment.”

  “The Shocker – a kind of punishment. Yes, that finished before Christmas. I couldn’t remember much after – your name, or Becky’s. My memory’s gradually come back, though there might be things I’ll never remember.” He looked sad, lost.

  She put her hand in his and was rewarded with a gentle squeeze. “Gosh, you’ve been going through it, John.”

  “I’ve had one or two adventures, but I won’t bore you with these.” The frown had gone. “It’s been okay since I was moved to the Annex. That’s a long-stay ward, and I must be twenty years younger than any of the others. A lot look senile or doped, but I hear some interesting tales.”

  “Do you think there’s a prospect of discharge yet?”

  The frown was back. “Nobody’s mentioned that. And –” John paused, the furrow on his brow deepening, “they say patients are in the Annex for life.”

  What she’d feared. “Oh, John.” He looked so miserable.

  “Apparently only a consultant psychiatrist can discharge a patient – and I’ve not seen one on this ward yet. They say he’s very busy. When I do see him, I’ll ask.” He bent forward and his face brightened. “Enough of me. How have you been, and Becky?”

  She told him about Becky’s progress and her work at the nursery. He kept nodding, with a dreamy faraway look she scarcely recognised. Mildly worrying, somehow. She began to speak more rapidly. There was so much to tell.

  Mid-sentence, a bell rang. She paused. “Fire alarm?”

  “I’ll find out.” John rose and went to ask a white-coat.

  “To let us know to wind up. We’ve about five minutes.” He sat down again.

  This awful place! “I’ve so much to tell you.”

  He stretched forward, and took her hand again. “Heather, I must have been more unhinged than I realised and had terrible unwanted thoughts. I’m through that, and I pine for you and Becky.” He stood up. “Please come again.”

  Her face awash, she hugged him. “John, I will.”

  But on the journey home, she still agonised. Had John properly recovered from his breakdown? His eyes lacked that vital spark, so characteristic when he was fit. Maybe they’d never release him anyway. If so, she’d always visit when she could. He was her true love. Yet the lure of Sam’s insistence remained strong, nagging away at a primal level. And he too had shown he loved her. Could she go along with Sam’s proposal – for now?

  Monday 21st January 1957 – in Aversham.

  It came as a shock. Heather was confiding in Moira about her liking for Sam, and what he’d suggested.

  “Mr Newman’s married, with a daughter,” Moira stated. “At least he was when I was still working. Sad – his wife had a long-term illness. Unless she’s died. I’ll find out for you.”

  Next day, Moira was back on the doorstep. “Me again, Heather. More news.”

  “Come in, Moira.”

  “I’ll just step inside. Can’t stop.” Moira pushed the door to. “I’ve checked on Sam. He lives in a council house with his wife and teenage daughter.”

  What! “You’re sure?” This decent caring man had misled her?

  “Absolutely. He’s been something of a lad, you know – had other women.”

  Friday 25th January 1957 – in Aversham.

  Heather had just put Becky to rest. The knocking on the door was faint, gentle. She opened the door and peered round it. Yes, it was Sam Newman.

  “How did your visit go, Heather?”

  “Okay thanks, Sam. Look, I won’t invite you in.” She gulped. She’d rehearsed for this moment. “About your proposition, the answer’s a definite ‘no’.”

  “Why, Heather?” He looked puzzled, deflated.

  “I love John. And I know you’re a married man with a family.”

  “But –” He gesticulated with his hand.

  “Thanks for all your help, Sam. But there’ll be no romance. And it’s better you don’t come round here again.”

  “But –” Was he going to cry? And was she?

  “I must go. ’Bye, Sam.” He was still standing there. She closed the door, then ran to the living room and, weeping silently, threw herself into the armchair.

  *

  Sam Newman limped into his car and sat in the dim lamplight, fumbling for his fags and lighter. Hell of a shock. And she’d shut the door in his face! He looked back at the door. He felt like going and banging on it, breaking it down. After all he’d done for the bitch. And she’d led him on! How did she know he was married?

  Blowing smoke rings, he calmed. Maybe in a month or two he’d go round, try persuading her to change her mind about an affair. The husband wouldn’t ever get home anyway. He started up and moved off slowly, back to Ella and Helen.

  49

  Tuesday 5th February 1957 – in Springwe
ll.

  It was Jamie Macdonald’s second morning in the job. And this was a vital meeting, with key folk that he needed to go along with him.

  “There’ll be a bloody revolution,” said Davies.

  “Yes – bloody, literally,” added Cope.

  Macdonald decided not to break the silence. This response to the vision he’d outlined – of a caring institution, without locked doors or padded cells or barriers to community involvement – was expected. He’d figured neither the HMC Chairman nor the Secretary would embrace radical change.

  Chief Macnamara came in. “Sure, there needs to be a revolution in patient care. Some of our practices are from a bygone era, before we had the chemical cosh and effective anti-psychotic drugs.”

  “Blind us with jargon if you like. It’s not safe,” said Davies.

  Matron Caroline spoke. “I understand your fears. We’ll have to go carefully, and staff will need a lot of reassurance. But let’s remember that we’re a hospital, to treat and care for our mentally afflicted fellows. Any one of us” – she looked round the room – “could have a breakdown. Would we want to be cooped up, imprisoned, and thrown into isolation if we behaved oddly?”

  The debate ran on. With solid backing from his two Heads of Nursing and Kenney, he secured the reluctant cooperation of the two doubters.

  Wards would be unlocked from Monday 4th March. Seclusion in padded cells was to be used only for patients likely to harm themselves. And he’d bring proposals to Committee for refurbishment to transform them into small single rooms. Here again, the support of his three allies would be vital in swaying the lay members – and the Chairman and Secretary agreed not to vote against the changes in Committee.

  Wednesday 6th February 1957 – in Springwell.

  Another critical meeting – for all staff this time – in the Main Hall. Macdonald outlined his proposals to abolish pillars of the old regime – the locked wards, the padded cells and the airing courts. Then, from the platform, he and his three lieutenants – Kenney, Matron Caroline and Chief Macnamara – listened to comment and joined in the (often heated) debate. It was memorable, atmospheric and, for much of the time, uncomfortable.

  Unlocking of wards went down like a blunt knife on granite. Reactions ranged from disbelief and ridicule (with one male nurse saying, too audibly, “Guy’s a nutter” – and getting a ripple of laughter), to more rational objections: “Impractical for us to keep control” and “unsafe – for the patients, us, and the outside world.”

  Abandoning padded cells was marginally less controversial. “Mayhem,” “needed for violent lunatics to let out their madness,” and “vital to cool the bad boys and teach them a lesson,” were among the comments.

  The phasing out of airing courts wasn’t too popular either. “How will they get their exercise?” and “it’ll be murder for the lot of us – having them cooped up all day,” were two of the comments.

  The loudest protest came from the COHSE branch chairman. “I am astounded by this madness. This is the lunatics running the asylum.” The man, a pompous nursing assistant with powers of oratory, added, “Chaos and murder will ensue. Our Union will support any members in industrial action.” The applause was roof-challenging.

  Matron Caroline spoke quietly, passionately. “Working with mentally afflicted folk in here is one of the toughest and most worthwhile jobs anywhere. Remember, for long enough we’ve had the chemical cosh to subdue the violence – as a last resort, when somebody’s out of control. Physical restraints of the past have no place in modern psychiatry.” She got mild applause. Was this a measure of support for the changes, or a spontaneous response to Caroline’s charming eloquence?

  Joe Macnamara said, “And the phenothiazines herald a pharmacological revolution that gives real hope in treating psychoses.”

  Macdonald went on to outline his vision. Springwell would evolve into a truly caring community. Occupational therapists and art therapists would be appointed, to provide helpful activity for patients. Barriers to the world outside would be lowered and community involvement encouraged. And psychiatric social workers would be appointed to work with patients and families, and help rehabilitate patients identified for discharge. The change process would extend over months, years.

  At the end of the meeting, he’d been encouraged to hear some applause. Polite and mild, but better than the boos and catcalls he’d feared.

  Monday 4th March 1957 – in Springwell.

  Macdonald had remained firm through lobbying and protests. All wards must be unlocked as from today.

  Morning, he toured the male wards with Macnamara, speaking with the charge nurses, listening, supporting, debating – and on Refractory, having to insist the ward door be unlocked. Matron and Kenney toured the female wards – and their cautiously optimistic report indicated less resistance there.

  Afternoon, they all toured again. A fight on Male Refractory had been diffused via the chemical cosh. A couple of wandering patients from Male Annex were found in the corridors and escorted back. Maybe there was a case for locking the Annex wards to keep senile patients secure?

  It was now evening on this momentous day.

  The internal phone startled him. “Jamie Macdonald.”

  “Caroline.” Matron. “Trouble, Jamie. Sister on our Annex has reported a patient with senile dementia, Nellie Morgan, missing from the ward. She was last seen about two hours ago. My Assistants and I have searched the building and walked round the outside, with no joy. Sister blames the unlocking of doors, and says this would never happen in the old days.”

  Blast. Resistance from nurses, backed by COHSE, could derail his plans. “We’d better inform the police.”

  “I can contact them if you like?”

  “Aye. Thanks.” Made sense, as Caroline would have the patient’s details.

  “I’ll keep you posted and send you a report about the incident. And I propose no disciplinary action against Sister or her staff – unless any are found to be deliberately negligent. They’ve been short-staffed today.”

  This Matron was outstanding – not only ready to take things on, but a brilliant ally in reforming. She had, with Kenney’s backing, begun the change process before he arrived. And the tour round with her on his first day was a heartening experience.

  The internal phone again. He snatched the receiver. “Jamie Macdonald.”

  “Caroline, Jamie. Police with dogs are on their way. They’re coming to my office for details. I’ll bring them straight over.”

  He sat waiting.

  He’d known it wouldn’t be easy. Mac Bell had made bold moves in the right therapeutic direction by unlocking Dingleton for the world’s first open-door mental hospital, and trying to involve the community in its life. But the changes had inevitably brought difficulties, which Mac was honest about in last year’s paper for the International Journal of Social Psychiatry.

  Matron appeared, with two great-coated policemen and their dogs. “Matron’s briefed us, Sir,” the sergeant declared. “We’ve each got a lamp and a torch.” They set off.

  “I’ll stay in my office for news, Jamie.”

  An unusually strained expression on her finely-cut features reflected the seriousness of this situation. “Thanks, Caroline.”

  Again, he sat waiting.

  Thank God Caroline was Matron. With her talents and passion, she’d have been effective in the skin of a monster. She was also so damned attractive. If he’d been single… Wed to her profession.

  “An unclaimed treasure,” Uncle Frank would have said. A phrase the young Jamie had unthinkingly taken as a tribute to an unmarried woman’s beauty.

  He remembered the moment of enlightenment. Sitting in a quiet corner of Mackie’s in Princes Street with fellow student Gill, meaning to sympathise with her over the death of her unmarried great aunt, the phrase slipped out.

  Gill had stood up. “What patronising bilge,” she hissed, her cheeks colouring. “You profess to support women’s rights and equality. Back to
claiming goods and chattels, are we?” She stomped off to the ladies’ lav.

  Stunned, he’d sat in silence, eyeing the table, feeling the stare of Edinburgh’s tongue-waggers, realising everything he’d heard was true, hoping this woman he fancied would come back to join him.

  She did. And, leaving the café together without ordering, they apologised to each other (he for a naivety that didn’t reflect how he saw women, she for a rash public outburst that didn’t reflect how she saw him) as they walked hand-in-hand along Princes Street.

  That had been make-or-break with Gill, and the frankness drew them closer.

  Maybe he’d write up his experiences at Springwell after a few years. The psychiatric community was too damned conservative. And the legal framework needed a drastic overhaul. As in Scotland, where the main substantive law was Victorian, in England the 1890 Lunacy Act still applied. Ludicrous!

  Aye, the 1930 Mental Treatment Act had re-named asylums, advocated setting up outpatient clinics, and introduced a ‘voluntary patient’ category. Folk could go into a mental hospital without having to be certified. Big deal. Most institutions had kept harsh stigmatising regimes, and voluntary patients bold enough to try leaving without psychiatrist blessing often found themselves certified and detained.

  In Melrose, he’d looked impatiently to a committee being set up to recommend a new legal framework for Scotland. And here in England it was a Royal Commission, set up in 1954. Subsequent law should sweep away anachronisms and improve the lot of the mentally distressed. But he wasn’t waiting for that.

  Someone was knocking on his door. The police or Caroline? He leapt to his feet. “Come in.” It was the sergeant, with dog on leash.

  “Sir, we’ve found the body of an elderly female floating in your pond.”